DETECTION OF PNEUMOCYSTIS-CARINII WITH DIRECT FLUORESCENCE ANTIBODY AND CALCOFLUOR WHITE STAIN

Direct fluorescence monoclonal antibody stain (DFA) was compared prosp ectively, with calcofluor white (CFW) stain for the diagnosis of Pneum ocystis carinii in 163 respiratory specimens from 97 patients, The pat ient population included persons with HIV infection (58%), bone marrow transplant recipients (10%), immunosuppressed patients owing to chemo therapy (21%) and others (11%). Nineteen specimens including 12 sputa, six bronchoalveolar lavage fluids (BALs) and one induced sputum were positive by DFA, In contrast, only six sputa, and five BALs were posit ive by CFW, All specimens positive by CFW were also positive by DFA. O f 86 sputa that were negative by either method 29 were followed by mor e invasive sample collections, Three specimens were followed by induce d sputum collection, 18 by BAL, six by lung biopsy, and two by pleural fluid aspiration, All the subsequent induced sputa, pleural fluids, a nd lung biopsies were negative by both methods, However, four of 18 su bsequent BALs (22%) were positive by both methods, provided at least t wo CFW stained slides were examined per specimen, Except for expectora ted sputum, it is concluded that CFW is a rapid and inexpensive test t o detect P. carinii in most respiratory specimens.